Organization Active NPI

Group 1 Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Atlanta, GA
National Provider Identifier
1245957604
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
GROUP 1 ORTHODONTICS, LLC
Practice address
1350 Spring St NW
Atlanta, GA 30309-2864
Phone
(770) 648-1082
NPI assigned
Oct 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Theodore Markos, DMDNPI 1295915767
Title
President/ Dentist
Phone
(617) 909-5459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1350 Spring St NW
Atlanta, GA 30309-2864

Mailing address

23 Olde Village Dr
Salem, MA 01970-1782
Phone (617) 909-5459

National Provider Directory

National Provider Directory

Locations

1350 Spring St NW
Atlanta, GA 30309
Phone (770) 648-1082

3186 Lawrenceville Suwanee Rd
Ste 5
Suwanee, GA 30024
Phone (770) 222-2322

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1245957604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 OLDE VILLAGE DR",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701782",
            "telephone_number": "617-909-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SPRING ST NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092864",
            "telephone_number": "770-648-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP 1 ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "MARKOS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "PRESIDENT/ DENTIST",
        "authorized_official_telephone_number": "617-909-5459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.